Negative Perceptions, Low Knowledge, and Social Stigma as Barriers to Preconception Care in Primary Health Care

Preconception care (PCC) is an important prevention strategy in primary health care to optimize maternal and fetal health outcomes by addressing pre-pregnancy risks. Although it is beneficial, utilization rates remain very low among women of reproductive age (WRA) in low- and middle-income countries (LMICs), including Indonesia. This qualitative study aims to explore perceptions, knowledge, barriers, and implementation strategies related to pre-pregnancy health screening among WRA who utilize PHC. In-depth interviews were conducted on 21 informants recruited by the purposive method from the Primary Health Center (PHC) in Denpasar City, Bali, Indonesia. Thematic analysis is used to identify the main themes of the transcribed data. Four main themes emerged that are (1) perceptions of pre-pregnancy screening vary from WRA, (2) knowledge levels that tend to be low about PCC, (3) the existence of barriers to access to services, social stigma and screening time constraints, and (4) the integration of screening services as a strategy to increase service coverage. These findings conclude that negative perceptions, low levels of knowledge and access barriers, social stigma and time constraints are related to the low utilization of preconception health screening. These findings contribute to the improvement of global health status. Future policies are implemented to prioritize stigma reduction, knowledge enhancement and expand access through the integration of pre-pregnancy health screening services with Community Clinic to increase the coverage of PCC.